PURPOSE: Pulmonary metastases from colorectal carcinomas have been reported to occur in 10% of all patients who undergo a curative resection. A number of studies have reported aggressive treatments, including lung resection, for pulmonary metastases that appear to prolong the survival in selected cases. The aim of this study was to assess the clinical characteristics, and the prognostic factors of pulmonary metastases, as well as the outcomes after resection of the pulmonary metastases. METHODS: A retrospective study was performed on 104 patients who presented with primary pulmonary metastases without metastases in other organs after a curative resection for a colorectal carcinoma between January 1994 and December 2000 at Asan Medical Center. Pulmonary metastases were diagnosed by using serial changes in the chest X-ray and the CT. Univariate (log-rank) and multivariate (Cox's model) analyses were employed to identify the prognostic factors. RESULTS: The mean interval between colorectal resection and pulmonary metastases (disease-free interval) was 22 (range: 4~64) months. Fifty-eight of 104 patients had pulmonary metastases originating from rectal cancer. More than half of the patients (55.7%) had bilateral multiple metastases. Fifty-six of 104 patients underwent chemotherapy, 28 conservative therapy, and 20 a pulmonary resection with the extent of the resection varying from a wedge resection of the metastatic nodule to a lobectomy. Prolonged survival was associated with serum CEA levels at the diagnosis of the metastases (P=0.02) and with the type of treatment (P<0.01). CONCLUSIONS: The s-CEA level at the diagnosis of the pulmonary metastases appears to be a reliable predictor of survival in patients with pulmonary metastases from colorectal cancer. Resection of the pulmonary metastasis in colorectal cancer may significantly prolong survival. Thus, aggressive therapy, including surgery, should be considered for pulmonary metastatic tumors in selected groups.
Carcinoembryonic Antigen ; Chungcheongnam-do ; Colorectal Neoplasms* ; Diagnosis ; Drug Therapy ; Humans ; Lung ; Lung Neoplasms ; Neoplasm Metastasis* ; Rectal Neoplasms ; Retrospective Studies ; Thorax ; Treatment Outcome

BACKGROUND/AIMS: In Korea, limited data are available on small bowel bleeding in patients with portal hypertension. This study reports on the use of capsule endoscopy in cases of suspected small bowel bleeding in patients with portal hypertension. METHODS: Capsule endoscopy was used at our hospital to evaluate small bowel disease in 501 cases from July 2003 to June 2010. Of those cases, nine patients with portal hypertension due to liver cirrhosis with suspected small bowel bleeding were selected for the study. A retrospective analysis was performed using data from medical records. RESULTS: Six of the nine (66.7%) patients were males with an average age of 53.4 years. The average hemoglobin level was 8.1 g/dL. Abnormalities noted during capsule endoscopy included portal hypertensive enteropathy in all nine cases (100%), jejunal varices in four (44.4%), jejunal and ileal angiodysplasia in five (55.5%), multiple small bowel erosions in one (11.1%), granularity of the jejunal mucosa in one (11.1%), and small bowel erythema in three (33.3%). Active bleeding from jejunal varices was detected in two patients (22.2%). Despite having no obvious active bleeding during the capsule endoscopy, four patients (44.4%) were diagnosed with portal hypertensive enteropathy with obscure small bowel bleeding. CONCLUSIONS: Capsule endoscopy is a useful diagnostic tool for the evaluation of small bowel bleeding in patients with portal hypertensive enteropathy. Additional prospective and multicenter studies on the use of capsule endoscopy are needed to evaluate the incidence and clinical importance of portal hypertensive enteropathy.
Angiodysplasia ; Capsule Endoscopy ; Erythema ; Hemoglobins ; Hemorrhage ; Humans ; Hypertension, Portal ; Incidence ; Korea ; Liver Cirrhosis ; Male ; Mucous Membrane ; Retrospective Studies ; Varicose Veins

Intussusception occurs when a segment of the bowel invaginates into the lumen of an adjacent distal segment. Intussusception in adults is a rare disease, accounting for only 5% of all cases. Asymptomatic small bowel intussusception in adults without a lead point is usually transient. When the length of the intussusception is less than 3.5 cm, it can be managed conservatively. This case was an asymptomatic small bowel intussusception without a lead point, which was discovered incidentally during an abdominal computed tomography scan. Spontaneous reduction in the intussusception was observed without any complications while maintaining conservative treatment only.
Accounting ; Adult ; Humans ; Intestine, Small ; Intussusception ; Rare Diseases

Pneumatosis cystoides intestinalis (PCI) is an uncommon condition in which submucosal or subserosal gas cysts are present within the bowel wall. We report a case of a 37-year-old man with no medical history. He underwent a colonoscopy for screening purposes, which revealed multiple and variably sized submucosal tumors in the ascending colon. Endoscopic ultrasonographic (EUS) finding showed multiple hyperechogenic regions with distal acoustic shadowing within the submucosa of the ascending colon. A computed tomography scan showed multiple air-filled cystic masses in the ascending colon. EUS appears to be effective for the diagnosis of PCI.
Acoustics ; Adult ; Colon, Ascending ; Colonoscopy ; Endosonography ; Humans ; Mass Screening ; Pneumatosis Cystoides Intestinalis ; Shadowing (Histology)